Citation NR: 9624782
Decision Date: 08/30/96 Archive Date: 09/04/96
DOCKET NO. 93-26 515 ) DATE
)
)
On appeal from the
Department of Veterans Affairs Regional Office in Boston,
Massachusetts
THE ISSUE
Whether new and material evidence has been submitted to
reopen a claim of entitlement to service connection for a
right great toe disability.
REPRESENTATION
Appellant represented by: Massachusetts Department of
Veterans Service
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
Carole R. Kammel, Associate Counsel
INTRODUCTION
The veteran served on active duty from January 1975 to May
1976.
This matter comes before the Board of Veterans’ Appeals
(Board) on appeal from a March 1992 rating decision of the
Department of Veteran Affairs (VA) Regional Office (RO) in
Boston, Massachusetts. This case was previously remanded by
the Board in July 1995. The Board finds that new and material
evidence has been submitted to reopen the veteran’s claim.
This decision by the Board therefore will be based on a
review of the entire evidence of record.
CONTENTIONS OF APPELLANT ON APPEAL
The veteran contends, in essence, that his right great toe
disability is a result of an injury he sustained during
service. He alleges that a steel hammer jack landed on his
right great toe.
DECISION OF THE BOARD
The Board, in accordance with the provisions of 38 U.S.C.A.
§ 7104 (West 1991 & Supp. 1995), has reviewed and considered
all of the evidence and material of record in the veteran's
claims files. Based on its review of the relevant evidence
in this matter, and for the following reasons and bases, it
is the decision of the Board that service connection for a
right great toe disability is warranted.
FINDINGS OF FACT
1. All relevant evidence necessary for an equitable
disposition of the appeal has been obtained.
2. Degenerative changes of the right first
metatarsophalangeal joint shown by X-ray are residuals of an
injury sustained by the veteran in January 1976 in service.
CONCLUSION OF LAW
Service connection for residuals of a right great toe injury
is in order. 38 U.S.C.A. §§ 1110, 1131, 5107 (1991);
38 C.F.R. § 3.303 (1995).
REASONS AND BASES FOR FINDINGS AND CONCLUSION
In a rating decision dated in July 1988, the RO denied the
veteran’s claim for service connection for a right great toe
disability. Evidence that was of record at the time of the
July 1988 rating decision included the veteran’s service
medical records, numerous VA outpatient reports and
examinations.
The veteran’s service medical records show that in January
1976, the veteran reported that a cooler from an air
compressor fell on his right great toe. The assessment of
the examiner was a contusion of the right great toe. The
next day, the veteran had a hole punched in the nail of his
right great toe to release the pressure. At separation
examination in March 1976, the veteran’s feet were found to
be normal.
Various VA outpatient and private reports show treatment for
other disabilities. A VA outpatient report dated in March
1988, reported that the veteran had stubbed his right great
toe on a sidewalk one week previously. The veteran reported
that he had gone to a VA clinic and had an X-ray performed
which showed no evidence of any fracture. In a rating
decision dated in July 1988, the RO determined that no right
great toe disability was found on VA examinations in November
1982 and September 1983 and denied service connection for
such disability.
The evidence received since the rating decision in July 1988,
includes various VA outpatient reports and hearing testimony.
In a hearing held at the RO in April 1993, the veteran
testified that he had injured his right great toe when a
steel hammer landed on it. He reported that he was placed on
light duty for 30 days. The veteran reported that from 1976
to 1992, he had not received any treatment for his right
great toe and that he self medicated it. He testified that
he avoided walking on his toe and that he placed a little tab
under it. The veteran stated that the last time he had
received any treatment for his right great toe was in 1992 at
the VA in Roxbury.
Various post service VA outpatient reports from January 1990
to June 1995 show that the veteran received treatment for his
right great toe on several occasions. In February 1992, the
veteran complained of chronic great toe pain. An X-ray at
that time, revealed a small cyst on the articular surface of
the distal end of the first metatarsal. It was noted that
the metatarsophalangeal joint was slightly narrowed, but that
the remaining bones of the right foot were normal. The
appearance suggested that the veteran probably had a cyst;
however, it was also reported that it might have been an
osteoid osteoma. The assessment of the examiner was slight
arthritis of the first metatarsophalangeal joint which was to
be ruled out with no evidence of any dysfunction. In July
1992, the veteran reported that he had sustained a jack
hammer injury to this right great toe 17 years previously
during service. The veteran complained of a sharp pain in
the toe and a feeling of “giving out”. He had an
intermittent sharp pain in the anterior interphalangeal joint
in the arch and in the upper right extremity at the edge of
his toe nail. His sensation was intact to deep palpation and
light touch with no evidence of numbness or tingling. The
veteran had normal range of motion for both his right ankle
and foot. The examiner stated that the veteran’s problems
appeared to be neurological. It was also noted that the
veteran had not worked since 1976. An X-ray performed in
April 1995, revealed no acute fractures or dislocations with
mild osteoarthritis in the first metatarsophalangeal joint.
A subsequent X-ray dated in June 1995, revealed some
degenerative joint disease of the first metatarsophalangeal
joint, but there was no evidence of any other acute or
chronic bone or joint abnormality.
The evidence submitted by the veteran since the July 1988
rating decision demonstrates that the veteran has
degenerative joint disease of the first metatarsophalangeal
joint. Although the inservice right great toe injury did not
result in immediate disability, it was of such severity as to
necessitate punching a hole in the nail to reduce swelling.
In the opinion of the board, it is as least as likely as not
that the current degenerative changes of the right great toe
are related to the inservice trauma. Resolving the benefit of
the doubt in the veteran’s favor, service connection for the
residuals of a right great toe injury is warranted.
38 U.S.C.A. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303.
ORDER
Service connection for residuals of a right great toe injury
is granted.
_____________________________
WAYNE M. BRAEUER
Member, Board of Veterans' Appeals
The Board of Veterans' Appeals Administrative Procedures
Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, 741
(1994), permits a proceeding instituted before the Board to
be assigned to an individual member of the Board for a
determination. This proceeding has been assigned to an
individual member of the Board.
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West
1991 & Supp. 1995), a decision of the Board of Veterans'
Appeals granting less than the complete benefit, or benefits,
sought on appeal is appealable to the United States Court of
Veterans Appeals within 120 days from the date of mailing of
notice of the decision, provided that a Notice of
Disagreement concerning an issue which was before the Board
was filed with the agency of original jurisdiction on or
after November 18, 1988. Veterans' Judicial Review Act,
Pub. L. No. 100-687, § 402, 102 Stat. 4105, 4122 (1988). The
date which appears on the face of this decision constitutes
the date of mailing and the copy of this decision which you
have received is your notice of the action taken on your
appeal by the Board of Veterans' Appeals.
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